Familial clustering of diabetic nephropathy in Brazilian type 2 diabetic patients
Familial clustering of diabetic nephropathy in Brazilian type 2 diabetic patients
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DOI：
10.2337/diabetes.48.4.909
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发表时间：
1999-04-01
期刊：
影响因子：
7.7
通讯作者：
Gross, JL
中科院分区：
文献类型：
--
作者：
Canani, LH;Gerchman, F;Gross, JL
有证据表明1型糖尿病患者存在糖尿病肾病的遗传易感性。然而，对2型糖尿病患者的研究很少，其中大多数是在少数民族或高加索人身上进行的。本研究的目的是确定巴西2型糖尿病患者样本中是否存在糖尿病肾病的遗传易感性。有两个或两个以上的2型糖尿病兄弟姐妹的家庭被确定。已知糖尿病持续时间最长的受试者被认为是先证者，研究了约90名先证者及其107名糖尿病兄弟姐妹。在至少三个不同的场合，在无菌24小时尿样中测量尿白蛋白排泄率。根据尿白蛋白排泄率将先证者和同胞分类为正常（200 μ g/min）。终末期肾病患者被纳入大量白蛋白尿组。正常白蛋白尿先证者的兄弟姐妹中有5.2%的人出现大量白蛋白尿，大量白蛋白尿先证者的兄弟姐妹中有24.1%的人出现大量白蛋白尿（P = 0.024）。在多元逻辑回归中，先证者糖尿病肾病的存在（微量或大量白蛋白尿和终末期肾病）与兄弟姐妹糖尿病肾病的存在显著相关（比值比= 3.75，95% CI = 1.36-10.40，P = 0.011）校正先证者空腹血糖和糖尿病病程，对这些结果的解释应考虑包括患有糖尿病肾病的兄弟姐妹的家庭可能被过度计数的可能性，另一方面，没有糖尿病肾病的兄弟姐妹可能被低估。在该2型糖尿病患者样本中存在糖尿病肾病的家族聚集性。
There is evidence for genetic predisposition to diabetic nephropathy in type 1 diabetic patients. However, there are few studies on type 2 diabetic patients, and most of those have been conducted on ethnic minorities or Caucasian individuals. The aim of this study was to ascertain the presence of an inherited predisposition to diabetic nephropathy in a sample of Brazilian type 2 diabetic patients. Families with two or more type 2 diabetic siblings were identified. Subjects with the longest duration of known diabetes were considered probands, Some 90 probands and their 107 diabetic siblings were studied. Urinary albumin excretion rate was measured in a sterile 24-h urine sample on at least three different occasions. Probands and siblings were classified according to urinary albumin excretion rate as normo- (200 mu g/min). Patients with end-stage renal disease were included in the macroalbuminuric group. Macroalbuminuria was identified in 5.2% of the siblings of normoalbuminuric probands and in 24.1% of the siblings of macroalbuminuric probands (P = 0.024). In multiple logistic regression, the presence of diabetic nephropathy in probands (micro- or macroalbuminuria and end-stage renal disease) was significantly associated with the presence of sibling diabetic nephropathy (odds ratio = 3.75, 95% CI = 1.36-10.40, P = 0.011) adjusted for proband fasting plasma glucose and diabetes duration, Interpretation of these results should take into account the possibility that the families including siblings with diabetic nephropathy may have been overcounted and, on the other hand, that the siblings without diabetic nephropathy may have been undercounted, In conclusion, there is a familial aggregation of diabetic nephropathy in this sample of type 2 diabetic patients.